Acute ventriculoperitoneal shunt malfunction following opening of the spinal subarachnoid space.

摘要

Dear Editor: I have read with interest the case series reported by Tubbs et al. [8] regarding spinal procedures in patients with shunts. All clinicians who care for these patients need to be aware of this condition because patients can deteriorate rapidly after any procedure that opens the subarachnoid space, including detethering, lumbar puncture, and placement of a lumboperitoneal shunt. The authors found the shunts to be functioning at the time of exploration. They propose that the cause of the malfunction was partial obstruction of the ventricular catheters by choroid plexus. Drainage of the spinal fluid from the spinal subarachnoid space then led to complete occlusion of the catheter. A discussant proposed a second potential explanation: The cause could have been a poorly positioned ventricular catheter [7].